Acute and subacute toxicity study of the ethanol crude extract of Leptadenia hastata plant (Pers.) Decne. in Wistar rats

Background: From a long time in history medicinal plants have been used traditionally for the treatment of many diseases. The plant Leptadenia hastata (Pers.) Decne of the family Asclepiadaceae has been used in the management of many ailments.Objective: This experimental research was designed to evaluate the toxicity profile of the ethanol whole plant extract of Leptadenia hastata in Wistar rats.Material and Methods: Five groups of rats were used for the toxicity study in which group 1 was used as control while Groups 2, 3, 4 and 5 were administered 200, 400, 800 and 1600 mg/kg of the extract. Subacute toxicity study was carried out for 30 days by oral administration of the different doses of the extract and blood samples were taken for biochemical and haematological investigation. Histopathological study was also conducted on pancreas, liver, kidney and heart.Results: The LD50 for acute toxicity study of the extract was found to be greater than 5000 mg/kg indicating relative safety. From the subacute study, there were no significant changes in the levels of the biochemical and haematological parameters when compared with the control group except for AST, ALP, HCO3+, MCV, platelets and platelet width distribution. Likewise, the morphological and histological investigations showed that the colour and architecture of the harvested organs were preserved with no signs of inflammation or distortions in their appearances when compared with the control.Conclusion: The results of this study indicated that the extract of Leptadenia hastata was found to be relatively safe.Keywords: Leptadenia hastata, Acute and Sub-acute toxicit

Synchronous Bilateral Breast Carcinoma: A Clinicopathological Report of a Rare Case with Treatment Challenges

Synchronous bilateral breast carcinoma (SBBC) is rare manifestation with an incidence ranging from 0.2% to 12%. The prognosis of the disease, its histopathological characteristics, and the molecular behaviour remain unclear. However, many studies have indicated independent chromosomal abnormalities from the two cancers that show an increase CXCR4 receptor expression with a high tendency of visceral metastasis. To date there are no standard protocols for treatment of SBBC and these pose challenges in interpreting survival data and recurrence. A 39-year-old female para 5+1, four alive presented with a 2-year history of a left breast lump and one-year history of a right breast lump. Both lumps were painless and progressively increased in size. The breasts show lumps at the upper outer quadrants measuring 7 x 6 and 6 x 5cm for left and right breast respectively, the overlying skin shows peud'orange. Biopsies confirmed SBBC with a discordant histology with triple-negative hormonal status. The patient had bilateral radical mastectomy and chemotherapy. We present a case of SBBC to re-emphasize the significance of screening for contralateral breast in patients who present with unilateral breast cancer. The standard treatment guideline is still lacking in the management of SBBC worldwide, therefore, multi-institutional prospective studies with long time follow-up of the patients are required for a better management of SBBC

Primary Cervical Burkitt's lymphoma masquerading tuberculous adenitis: a case report and review of the literature

Burkitt's lymphoma (BL) is the most highly aggressive and rapidly growing tumour ever known in humans that appears to occur in three histologically and phenotypically identical but clinically distinct forms; endemic, sporadic and the immunodeficiency-associated variant. There is considerable overlap among these distinct variants. The endemic form is most commonly observed in equatorial Africa, in children aged 4-7 years, with frequent involvement of the mandible and facial bones. In contrast, in other geographic regions, most patients present with abdominal tumours and have no specific geographic or climatic distribution.  An 8-year-old Negro boy presented with swelling on the right side of the neck for three weeks, with a progressive increase in size. He had drenching night sweat, but no associated fever. No history was suggestive of congenital immunodeficiency syndrome. Examination of the neck revealed right-sided cervical lymphadenopathy that was firm and matted, not tender, nor other features of inflammation. Histology showed nodal architecture that was effaced by malignant lymphoid neoplasm with prominent nucleoli and scanty cytoplasm, as well as brisk mitotic activity with numerous macrophages in an inflammatory background. The immuno-histochemical profile of the tumour was CD20 and CD10 positive with BCl-2 and CD15 negative. Human immunodeficiency virus serology was negative. Burkitt’s lymphoma arising exclusively from lymph nodes may mimic tuberculous adenitis while a potentially curable tumour, with cautious use of appropriate combination chemotherapy, its treatment is quite distinct from that of tuberculosis. Cheaper generic formulation are readily available. It is conceivable to conclude that with efficient supportive therapy, BL is no longer life-threatening cancer in children

Gestational Gigantomastia: Report of a Rare Case and Literature Review

Background: Gestational gigantomastia is a rare disorder with unknown aetiology. It commonly occurs during the first and early second trimesters and mostly affects women during their second and third decades of life. The disease has been reported to be more common among Caucasians than Blacks and involves both breasts in 92% of cases. There are no standard treatment protocols for the disease, however, both medical use of bromocriptine and simple mastectomy have been applied. Case summary: We present a case of 32-year-old un-booked female, G8P7+0, 7 alive, who presented with bilateral breast enlargement with ulceration at 25 weeks’ gestation. The diagnosis was confirmed by tissue biopsy and simple mastectomy was done and the pregnancy was allowed to continue to term. Conclusion: This case report describes the first case of gestational gigantomastia in our environment and the seventh case reported in Africa to increase our awareness on how to diagnose and rule out other causes of bilateral massively enlarged breasts during pregnancy and the treatment options for this distressing clinical condition